İNTRAPARENKİMAL KANAMALI HASTALARDA ASA SKORUNUN MORTALİTE ORANINA ETKİSİ

Yıl 2022, Cilt: 29 Sayı: 2, 237 - 241, 30.06.2022

Turan Kandemir Serdar Ercan Kemal Ertilav Zeki Serdar Ataizi

https://doi.org/10.17343/sdutfd.1034219

Cited By: 1

Öz

Amaç
İntraparenkimal hematom nedeniyle opere ettiğimiz
hastaların hematom hacimleri ve preoperatif ASA
skorlarının mortaliteye etkisini değerlendirmeyi amaçladık.
Gereç ve Yöntem
Çalışmamız hastanemiz Beyin ve Sinir Cerrahisi kliniğinde
Şubat 2015 - Şubat 2020 tarihleri arasında
intraparenkimal hematom nedeniyle opere edilen 34
hastanın dosyaları geriye dönük olarak taranması ile
yürütüldü. Hastaların preoperatif glaskow koma skoru,
hematom hacmi, antiagregan kullanımı, hipertansiyon
varlığı, kanamanın lokalizasyonu ve ventriküle
açılıp açılmadığı ve ASA skorları değerlendirilmek için
toplandı.
Bulgular
Çalışmaya dahil edilen 34 hastanın 20’i erkek 14’ü
kadın hastaydı. Hastaların geliş anındaki ortalama
hematom hacimleri 120cm3 ( min:41 – max: 278
cm3)’dü. Hastaların takiplerinde 28 tanesi ex olmuş
olup mortalite oranımız %82’dir. Hematom hacimleri
ile mortalite arasında anlamlı bir ilişki saptanmıştır
(P<0.05). Hastaların 11’i ASA 2, 4’ ü ASA 3, 17’si ASA
4 ve 2 hasta ASA 5 olarak değerlendirilmiştir. Hastaların
ASA skoru ile mortalitesi değerlendirildiğinde anlamlı
bir ilişki saptanmamıştır( P>0.05).
Sonuç
Glaskow koma skoru ve ASA skoru mortaliteyi belirleyen
önemli faktörlerdir. Glaskow koma skoru ve ASA
skoru birlikte değerlendirilmelidir. Glaskow koma skoru
düşük bile olsa komorbid hastalıkları olmayan hastalarda
mortalite azalmaktadır.

Anahtar Kelimeler

İntraparenkimal hematom, Hematom hacmi, Glaskow koma skoru, ASA, Mortalite

Destekleyen Kurum

YOK

THE EFFECT OF ASA SCORE ON MORTALITY RATE IN PATIENTS WITH INTRAPARENCHYMAL HEMORRHAGE

Öz

Objective
We aimed to evaluate the effect of hematoma volumes
and preoperative ASA scores on mortality of the
patients we operated on due to intraparenchymal
hematoma.
Materials and Methods
This study was conducted by retrospectively scanning
the files of 34 patients operated on for intraparenchymal
hematoma in our hospital’s neurosurgery clinic
between February 2015 and February 2020. The
preoperative glasgow coma score, hematoma
volume, antiaggregant use, presence of hypertension,
localization of bleeding and whether it was opened
to the ventricle and ASA scores of the patients were
collected to evaluate.
Results
Of the 34 patients included in the study, 20 were male,
and 14 were female. Preoperative mean hematoma
volumes of the patients were 120 cm3 (min: 41 –
max: 278 cm3). In the follow-up of the patients, 28 of
them were dead, and our mortality rate was 82%. A
significant correlation was found between hematoma
volumes and mortality (P<0.05). 11 of the patients
were evaluated as ASA 2, 4 as ASA 3, 17 as ASA 4,
and 2 patients as ASA 5. No significant correlation
was found between the patients' ASA score and
mortality (P>0.05).
Conclusion
Glasgow coma score and ASA score are important
factors determining mortality. The glasgow coma
score and ASA score should be evaluated together.
Even if the glasgow coma score score is low, mortality
decreases in patients without comorbid diseases.

Anahtar Kelimeler

Intraparenchymal Hemorrhage, Hematoma volume, Glasgow coma score, ASA, Mortality

Kaynakça

• 1. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. The Lancet Neurology. 2009;8(4):355-69.
• 2. Hong K-S, Bang OY, Kang D-W, Yu K-H, Bae H-J, Lee JS, et al. Stroke statistics in Korea: part I. Epidemiology and risk factors: a report from the korean stroke society and clinical research center for stroke. Journal of stroke. 2013;15(1):2.
• 3. Krishnamurthi RV, Moran AE, Forouzanfar MH, Bennett DA, Mensah GA, Lawes CM, et al. The global burden of hemorrhagic stroke: a summary of findings from the GBD 2010 study. Global heart. 2014;9(1):101-6.
• 4. Broderick JP, Adams Jr HP, Barsan W, Feinberg W, Feldmann E, Grotta J, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 1999;30(4):905-15.
• 5. Flaherty M, Haverbusch M, Sekar P, Kissela B, Kleindorfer D, Moomaw C, et al. Long-term mortality after intracerebral hemorrhage. Neurology. 2006;66(8):1182-6.
• 6. Abouleish AE, Leib ML, Cohen NH. ASA provides examples to each ASA physical status class. ASA Monitor. 2015;79(6):38-49.
• 7. Bakır A, Yılmaz ER, Sarılar C, Tuna H, Çağlar Ş. İntraserebral Hematomlar. Türk Nöroşir Derg. 2006;16(1):42-44.
• 8. Evcili G, Ak H, Boro UT, Yaycioglu S. Evaluation of the Effects of Aspirin and Warfarin Use on the Volume of Intracranial Non-Traumatic Hemorrhage and Mortality Rate. Journal of Neurology Research. 2012;2(3):99-103.
• 9. Broderick JP. Advances in the treatment of hemorrhagic stroke: a possible new treatment. Cleveland Clinic journal of medicine. 2005;72(4):341-4.
• 10. Van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. The Lancet Neurology. 2010;9(2):167-76.
• 11. Tuhrim S, Horowitz DR, Sacher M, Godbold JH. Validation and comparison of models predicting survival following intracerebral hemorrhage. Critical care medicine. 1995;23(5):950-4.
• 12. Davis S, Broderick J, Hennerici M, Brun N, Diringer M, Mayer S, et al. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage. Neurology. 2006;66(8):1175-81.
• 13. Kanaya H. Current status of surgical therapy of hypertensive cerebral hemorrhage in Japan. Nihon rinsho Japanese journal of clinical medicine. 1982;40(12):2775-82.
• 14. Dolgun H, Hanalioğlu Ş, Gürses L, Gülce G, Başar İ, GÜNAYDIN A, et al. Spontan İntraserebral Hematomların Cerrahi Tedavisi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. (3):439-46.
• 15. An SJ, Kim TJ, Yoon B-W. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update. Journal of stroke. 2017;19(1):3.
• 16. Auer LM, Deinsberger W, Niederkorn K, Gell G, Kleinert R, Schneider G, et al. Endoscopic surgery versus medical treatment for spontaneous intracerebral hematoma: a randomized study. Journal of neurosurgery. 1989;70(4):530-5.
• 17. Hemphill III JC, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001;32(4):891-7.
• 18. Wang C-Y, Chen Y-C, Chien T-H, Chang H-Y, Chen Y-H, Chien C-Y, et al. Impact of comorbidities on the prognoses of trauma patients: Analysis of a hospital-based trauma registry database. PloS one. 2018;13(3):e0194749.
• 19. Rantner B, Eckstein H-H, Ringleb P, Woelfle KD, Bruijnen H, Schmidauer C, et al. American Society of Anesthesiology and Rankin as predictive parameters for the outcome of carotid endarterectomy within 28 days after an ischemic stroke. Journal of Stroke and Cerebrovascular Diseases. 2006;15(3):114-20.
• 20. Pateder DB, Gonzales RA, Kebaish KM, Cohen DB, Chang J-Y, Kostuik JP. Short-term mortality and its association with independent risk factors in adult spinal deformity surgery. Spine. 2008;33(11):1224-8.